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Reis LFCD, Cerdeira CD, Silva LCC, Ramos ABSB, Silva JEC, Castro AP, Ventura RR, Souza RLM, Marques MJ, Novaes RD. Dietary glycemic and energy load differentially modulates Schistosoma mansoni-induced granulomatous inflammation and response to antiparasitic chemotherapy. Acta Trop 2024; 252:107141. [PMID: 38342286 DOI: 10.1016/j.actatropica.2024.107141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/09/2023] [Accepted: 02/02/2024] [Indexed: 02/13/2024]
Abstract
The impact of diet composition and energy content on schistosomiasis evolution and treatment efficacy is still controversial. This study compared the impact of sucrose-rich diet and intermittent fasting on Schistosoma mansoni infection and praziquantel (PZQ)-based chemotherapy response in mice. BALB/c mice were infected with S. mansoni and followed for 15 weeks. The animals were randomized into nine groups receiving high glycemic load (high-sucrose diet - HSD), low caloric load (standard chow alternate-day fasting - ADF), and standard chow ad libitum (AL). Eight weeks after S. mansoni infection, these groups remained untreated or were treated with PZQ (300 mg/kg/day) for 3 days. Our results indicated that parasite load (S. mansoni eggs and parasite DNA levels), granulomatous inflammation (granulomas number and size), and liver microstructural damage (reduction in hepatocytes number, increase in nucleus-cytoplasm ratio, connective stroma expansion and fibrosis) were increased in ADF-treated animals. These animals also showed decreased eggs retention, granulomatous inflammation and collagen accumulation in the small intestine. Conversely, HSD diet and PZQ treatment attenuated all these parameters and stimulated hepatic regenerative response. PZQ also stimulated fibrosis resolution in HSD-treated mice, effect that was limited ADF-exposed mice. Our findings indicate that dietary glycemic and energy load can modulate schistosomiasis progression and the severity of hepatic and intestinal granulomatous inflammation in untreated and PZQ-treated mice. Thus, lower intestinal eggs retention may potentially be linked to worsening liver disease in ADF, while attenuation of hepatic and intestinal granulomatous inflammation is consistent with reduced parasite load in HSD- and PZQ-treated animals.
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Affiliation(s)
- Luis F C Dos Reis
- Instituto d e Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais 37130-001, Brazil
| | - Cláudio D Cerdeira
- Departamento de Bioquímica, Universidade Federal de Alfenas, Alfenas, Minas Gerais, 37130-001, Brazil
| | - Laís C C Silva
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Alfenas, Alfenas Minas Gerais, 37130-001, Brazil
| | - Amanda B S B Ramos
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Alfenas, Alfenas Minas Gerais, 37130-001, Brazil
| | - José Edson C Silva
- Programa de Pós-Graduação em Ciências Biológicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais 37130-001, Brazil
| | - Aline P Castro
- Instituto d e Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais 37130-001, Brazil
| | - Renato R Ventura
- Instituto d e Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais 37130-001, Brazil
| | - Raquel L M Souza
- Instituto d e Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais 37130-001, Brazil; Programa de Pós-Graduação em Ciências Biológicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais 37130-001, Brazil
| | - Marcos J Marques
- Instituto d e Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais 37130-001, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Alfenas, Alfenas Minas Gerais, 37130-001, Brazil; Programa de Pós-Graduação em Ciências Biológicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais 37130-001, Brazil
| | - Rômulo D Novaes
- Instituto d e Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais 37130-001, Brazil; Programa de Pós-Graduação em Ciências Biológicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais 37130-001, Brazil.
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Sakurai T, Nakamura M, Sasaki H, Fukuzawa T, Kudo H, Ando R, Okubo R, Hashimoto M, Tada K, Wada M. Risk factors for catheter-related bloodstream infections in patients with intestinal failure undergoing home parenteral nutrition: a single-center study. Pediatr Surg Int 2023; 39:283. [PMID: 37847289 DOI: 10.1007/s00383-023-05555-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE The incidence and risk factors of catheter-related bloodstream infections (CRBSI) in patients with intestinal failure (IF) have not been established, partly because catheter management methods vary from different facilities. This study aimed to identify the risk factors and incidence rate of CRBSIs in patients with IF who were given prophylactic treatment. METHODS Sixteen patients with IF who required home parenteral nutrition were enrolled in this study. Prophylactic management of CRBSI included monthly ethanol lock therapy and standardized infection prevention education. The outcomes included the incidence and risk factors of CRBSI. RESULTS The median incidence rate of CRBSI was 1.2 per 1000 catheter days. Univariate analysis showed that the risk of developing CRBSI was significantly associated with short bowel syndrome (< 30 cm) (p = 0.016). Other relevant findings included a significant negative correlation between serum albumin and CRBSI rate (r = - 0.505, p = 0.046), and past history of mixed bacterial infections was significantly associated with increased CRBSI rate (p = 0.013). CONCLUSION CRBSIs can still develop despite undergoing prophylactic management. Risk factors for CRBSI include the residual intestinal length, nutritional status, and susceptibility to certain microorganisms.
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Affiliation(s)
- Tsuyoshi Sakurai
- Department of Pediatric Surgery, Tohoku University Hospital, Sendai, 980-8574, Japan
| | - Megumi Nakamura
- Department of Pediatric Surgery, Tohoku University Hospital, Sendai, 980-8574, Japan
| | - Hideyuki Sasaki
- Department of Pediatric Surgery, Tohoku University Hospital, Sendai, 980-8574, Japan
| | - Taichi Fukuzawa
- Department of Pediatric Surgery, Tohoku University Hospital, Sendai, 980-8574, Japan
| | - Hironori Kudo
- Department of Pediatric Surgery, Tohoku University Hospital, Sendai, 980-8574, Japan
| | - Ryo Ando
- Department of Pediatric Surgery, Tohoku University Hospital, Sendai, 980-8574, Japan
| | - Ryuji Okubo
- Department of Pediatric Surgery, Tohoku University Hospital, Sendai, 980-8574, Japan
| | - Masatoshi Hashimoto
- Department of Pediatric Surgery, Tohoku University Hospital, Sendai, 980-8574, Japan
| | - Kesuke Tada
- Department of Pediatric Surgery, Tohoku University Hospital, Sendai, 980-8574, Japan
| | - Motoshi Wada
- Department of Pediatric Surgery, Tohoku University Hospital, Sendai, 980-8574, Japan.
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de Faria LM, Nobre V, Guardão LRDO, Souza CM, de Souza AD, Estrella DDR, Pessoa BP, Corrêa RA. Factors associated with pulmonary infection in kidney and kidney-pancreas transplant recipients: a case-control study. J Bras Pneumol 2023; 49:e20220419. [PMID: 37729335 PMCID: PMC10578948 DOI: 10.36416/1806-3756/e20220419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 07/15/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE To evaluate the etiology of and factors associated with pulmonary infection in kidney and kidney-pancreas transplant recipients. METHODS This was a single-center case-control study conducted between December of 2017 and March of 2020 at a referral center for kidney transplantation in the city of Belo Horizonte, Brazil. The case:control ratio was 1:1.8. Cases included kidney or kidney-pancreas transplant recipients hospitalized with pulmonary infection. Controls included kidney or kidney-pancreas transplant recipients without pulmonary infection and matched to cases for sex, age group, and donor type (living or deceased). RESULTS A total of 197 patients were included in the study. Of those, 70 were cases and 127 were controls. The mean age was 55 years (for cases) and 53 years (for controls), with a predominance of males. Corticosteroid use, bronchiectasis, and being overweight were associated with pulmonary infection risk in the multivariate logistic regression model. The most common etiologic agent of infection was cytomegalovirus (in 14.3% of the cases), followed by Mycobacterium tuberculosis (in 10%), Histoplasma capsulatum (in 7.1%), and Pseudomonas aeruginosa (in 7.1%). CONCLUSIONS Corticosteroid use, bronchiectasis, and being overweight appear to be risk factors for pulmonary infection in kidney/kidney-pancreas transplant recipients, endemic mycoses being prevalent in this population. Appropriate planning and follow-up play an important role in identifying kidney and kidney-pancreas transplant recipients at risk of pulmonary infection.
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Affiliation(s)
- Leonardo Meira de Faria
- . Faculdade Ciências Médicas de Minas Gerais - FCMMG - Belo Horizonte (MG) Brasil
- . Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG) Brasil
- . Hospital Felício Rocho, Belo Horizonte (MG) Brasil
| | - Vandack Nobre
- . Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG) Brasil
| | | | | | - Amanda Damasceno de Souza
- . Programa de Pós-Graduação em Tecnologia da Informação e Comunicação e Gestão do Conhecimento - PPGTICGC - Universidade FUMEC, Belo Horizonte (MG) Brasil
| | - Deborah dos Reis Estrella
- . Hospital Felício Rocho, Belo Horizonte (MG) Brasil
- . Programa de Pós-Graduação de Ciências Aplicadas em Saúde do Adulto, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG) Brasil
| | - Bruno Porto Pessoa
- . Faculdade Ciências Médicas de Minas Gerais - FCMMG - Belo Horizonte (MG) Brasil
| | - Ricardo Amorim Corrêa
- . Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG) Brasil
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Fauziah N, Aviani JK, Agrianfanny YN, Fatimah SN. Intestinal Parasitic Infection and Nutritional Status in Children under Five Years Old: A Systematic Review. Trop Med Infect Dis 2022; 7:371. [PMID: 36422922 PMCID: PMC9697828 DOI: 10.3390/tropicalmed7110371] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 09/01/2023] Open
Abstract
Intestinal parasitic infections are common infectious diseases causing many health problems and impaired growth and physical development.. Children under five years old are the most vulnerable to infections, due to their immature immunity and feeding and exploratory behaviours. This systematic review aimed to assess the relationship between intestinal parasitic infections and undernutrition among children under 5 years old. Fifteen studies met the inclusion and exclusion criteria and were classified as high-quality studies. Twelve parasites were reported, including Ascaris lumbricoides, Cryptosporodium spp., Entamoeba histolytica, Enterobius vermicularis, Giardia lamblia, hookworm, Hymenolepis nana, Strongyloides sterocalis, Taenia spp. and Trichuris trichuria. Ascariasis is the most reported infection, with a prevalence ranging from 10.77% in Ethiopia to 57.14% in Malaysia, and is correlated with stunting (OR 2.17 (95% CI 1.14, 4.13), p = 0.02). Giardiasis is the second most reported infection, with a prevalence ranging from 4.43% in Ethiopia to 66.33% in the Central African Republic, and is related to an increased risk of stunting (OR 2.34 (95% CI 1.07, 5.10), p = 0.03)), wasting (OR 2.90 (95% CI 1.12, 7.49, p = 0.03)), and being underweight (OR 1.53 (95% CI 1.02, 2.29, p = 0.04)). The third and fourth most prevalent infections are T. trichiura and hookworm infections. Intestinal parasitic infections can occur very early in life and cause significant growth retardation. It is important to understand the prevalence and effects of infection based on the parasite species in order to implement therapeutic interventions and prevention controls.
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Affiliation(s)
- Nisa Fauziah
- Division of Parasitology, Department of Basic Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, Indonesia
- Laboratory of Parasitology, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, Indonesia
- Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung 45363, Indonesia
| | - Jenifer Kiem Aviani
- Department of Biotechnology, School of Life Science and Technology, Institut Teknologi Bandung, Bandung 40132, Indonesia
| | - Yukan Niko Agrianfanny
- Laboratory of Parasitology, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, Indonesia
| | - Siti Nur Fatimah
- Division of Clinical Nutrition, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, Indonesia
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Kadji Fassi JB, Boukeng Jatsa H, Membe Femoe U, Greigert V, Brunet J, Cannet C, Kenfack CM, Gipwe Feussom N, Tienga Nkondo E, Abou-Bacar A, Pfaff AW, Kamgang R, Kamtchouing P, Tchuem Tchuenté LA. Protein undernutrition reduces the efficacy of praziquantel in a murine model of Schistosoma mansoni infection. PLoS Negl Trop Dis 2022; 16:e0010249. [PMID: 35839247 PMCID: PMC9328564 DOI: 10.1371/journal.pntd.0010249] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 07/27/2022] [Accepted: 06/28/2022] [Indexed: 01/03/2023] Open
Abstract
Background Undernutrition and schistosomiasis are public health problems and often occur in low and middle-income countries. Protein undernutrition can alter the host-parasite environment system and aggravate the course of schistosomiasis. This study aimed to assess the impact of a low-protein diet on the efficacy of praziquantel. Methodology/Principal findings Thirty-day-old mice were fed with a low-protein diet, and 40 days later, they were individually infected with fifty Schistosoma mansoni cercariae. A 28-day-treatment with praziquantel at 100 mg/kg for five consecutive days followed by distilled water begins on the 36th day post-infection. Mice were sacrificed on the 64th day post-infection. We determined the parasitological burden, liver and intestine histomorphometry, liver injury, and immunomodulation parameters. Praziquantel treatment of infected mice fed with a standard diet (IN-PZQ) resulted in a significant reduction of worm and egg burdens and a normalization of iron and calcium levels. The therapy also improved schistosomiasis-induced hepatopathy and oxidative stress. The anti-inflammatory and immunomodulatory activities of praziquantel were also significant in these mice. When infected mice receiving the low-protein diet were treated with praziquantel (ILP-PZQ), the body weight loss and hepatomegaly were not alleviated, and the worm and liver egg burdens were significantly higher than those of IN-PZQ mice (P < 0.001). The treatment did not reduce the increased activities of ALT and γ-GGT, the high malondialdehyde concentration, and the liver granuloma volume. The iron and calcium levels were not ameliorated and differed from those of IN-PZQ mice (P < 0.001 and P < 0.05). Moreover, in these mice, praziquantel treatment did not reverse the high level of IL-5 and the low mRNA expression of CCL3/MIP-1α and CXCL-10/IP-10 induced by S. mansoni infection. Conclusion/Significance These results demonstrated that a low-protein diet reduced the schistosomicidal, antioxidant, anti-inflammatory, and immunomodulatory activities of praziquantel. Almost 90% of people requiring schistosomiasis preventive chemotherapy in 2018 lived in sub-Saharan Africa. Besides, 205.3 million children under five years suffer and die of undernutrition in low- and middle-income countries. The physiopathology of schistosomiasis mansoni involves liver damage, oxidative stress, and perturbation of the immune response. These disturbances are intensified by undernutrition. Praziquantel is used to treat schistosomiasis, but its efficacy on the comorbidity of S. mansoni infection and undernutrition has not been investigated. We conducted this study to assess the effectiveness of praziquantel on S. mansoni infection in mice fed with a low-protein diet. We recorded growth retardation, hepatomegaly, and high worm and egg burdens in mice fed with a low-protein diet and treated with PZQ. Moreover, the treatment did not reverse the liver function injury, oxidative stress, high iron level, and low calcium level. The proinflammatory cytokine IL-5 was still high, and the gene expression of some macrophage-associated chemokines was reduced. Therefore, this study demonstrated that in a murine model of a low-protein diet, the efficacy of praziquantel on S. mansoni infection was reduced. It also underlines the importance of targeting protein deficiency and malnutrition in populations living in schistosomiasis endemic areas for efficient disease control.
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Affiliation(s)
- Joseph Bertin Kadji Fassi
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
| | - Hermine Boukeng Jatsa
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
- * E-mail:
| | - Ulrich Membe Femoe
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
- Institute of Parasitology and Tropical Diseases, Dynamic Host-Pathogen Interactions, University of Strasbourg, Strasbourg, France
| | - Valentin Greigert
- Institute of Parasitology and Tropical Diseases, Dynamic Host-Pathogen Interactions, University of Strasbourg, Strasbourg, France
| | - Julie Brunet
- Institute of Parasitology and Tropical Diseases, Dynamic Host-Pathogen Interactions, University of Strasbourg, Strasbourg, France
| | - Catherine Cannet
- Laboratory of Histomorphometry, Institute of Legal Medicine, University of Strasbourg, Strasbourg, France
| | - Christian Mérimé Kenfack
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
| | - Nestor Gipwe Feussom
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
| | - Emilienne Tienga Nkondo
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
| | - Ahmed Abou-Bacar
- Institute of Parasitology and Tropical Diseases, Dynamic Host-Pathogen Interactions, University of Strasbourg, Strasbourg, France
| | - Alexander Wilhelm Pfaff
- Institute of Parasitology and Tropical Diseases, Dynamic Host-Pathogen Interactions, University of Strasbourg, Strasbourg, France
| | - René Kamgang
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
| | - Pierre Kamtchouing
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
| | - Louis-Albert Tchuem Tchuenté
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
- Laboratory of Parasitology and Ecology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
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Afolami I, Samuel FO, Mwangi M, Oderinde M, Diepeveen-de Bruin M, Melse-Boonstra A. Assessment of small-intestine permeability in healthy Nigerian children is altered by urinary volume and voiding status. PLoS One 2021; 16:e0253436. [PMID: 34543276 PMCID: PMC8452060 DOI: 10.1371/journal.pone.0253436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 06/04/2021] [Indexed: 11/25/2022] Open
Abstract
Objective This study aimed to uncover the effect of voided urinary volume on small intestine permeability ratios in healthy children. Methods We assessed small intestine permeability in 155 apparently healthy children, aged 3–5 years old, without any visible symptoms of disease, in a rural, malaria-endemic setting in Nigeria, using a multi-sugar test solution, comprising lactulose, sucrose, mannitol, and rhamnose. Children were categorized into low urinary volume (LV) and high urinary volume (HV), based on the volume of urine voided per kg body weight per hour. LV children voided less than 25th percentile of the total population, while HV children voided greater than 75th percentile of the total population. Urinary volume excreted over a 90-minute period after administration of the test solution was measured, and differences in sugar ratios were compared between children with high (HV) and low urinary volumes (LV), as well as between children who voided (VC) or who were not able to void (NVC) before administration of the test solution. Results Urinary mannitol and rhamnose recovery were 44% (p = 0.002) and 77% (p<0.001) higher in HV children compared to LV children respectively, while urinary lactulose recovery was 34% lower (p = 0.071). There was no difference in urinary sucrose recovery between groups (p = 0.74). Lactulose-mannitol ratio, lactulose-rhamnose ratio and sucrose-rhamnose ratio were all significantly higher in children in the LV group compared to children in the HV group (p<0.001). In a multiple regression analysis, urinary volume and voiding status combined, explained 13%, 23% and 7% of the variation observed in lactulose-mannitol, lactulose-rhamnose and sucrose-rhamnose ratios, respectively. Conclusion Sugar permeability ratios vary significantly with total urinary volume in multi-sugar small-intestine permeability tests. Voiding status before sugar administration appears to influence lactulose recovery, lactulose-rhamnose and sucrose-rhamnose ratios independently of total urinary volume. Evidence from this study suggests the need to take urinary volume into account when conducting multi-sugar small-intestine permeability tests.
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Affiliation(s)
- Ibukun Afolami
- Department of Human Nutrition, University of Ibadan, Ibadan, Nigeria
- Department of Human Nutrition, Wageningen University & Research, Wageningen, the Netherlands
- * E-mail:
| | | | - Martin Mwangi
- Department of Human Nutrition, Wageningen University & Research, Wageningen, the Netherlands
| | - Michael Oderinde
- Department of Human Nutrition, University of Ibadan, Ibadan, Nigeria
| | | | - Alida Melse-Boonstra
- Department of Human Nutrition, Wageningen University & Research, Wageningen, the Netherlands
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Incidence and risk factors of postoperative complications in patients with tuberculosis-destroyed lung. BMC Pulm Med 2021; 21:273. [PMID: 34419012 PMCID: PMC8380317 DOI: 10.1186/s12890-021-01641-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to determine risk factors of postoperative complications in tuberculosis-destroyed lung (TDL) patients. Methods We retrospectively analyzed the data from all consecutive TDL patients undergoing surgical treatment at the Beijing Chest Hospital from January 2001 to September 2019. Results Of 113 TDL cases experiencing surgery, 33 (29.2%) experienced postoperative complications. The patients with low BMI were more likely to have postoperative complications compared to those with normal BMI, whereas a significant lower rate of postoperative complications was noted in patients with BMI ≥ 25 kg/m2. In addition, significant increased risk was observed in patients with smoking history. We found that the patients with underlying infection, including aspergillus and nontuberculous mycobacteria (NTM), had significantly higher odds of having postoperative complications compared with those without underlying infection. The anaemia was another important independent factor associated with postoperative complication. Patients with blood transfusion above 1000 mL had a strongly increased frequency of postoperative complications than patients with blood transfusion below 1000 mL. Conclusion In conclusion, our data demonstrate that approximate one third of TDL patients experience postoperative complications in our cohort. Patients with low BMI, anaemia, tobacco smoking, and coinfected aspergillus or NTM are at markedly higher risk to experience postoperative complications after pneumonectomy.
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8
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Mahluji S, Jalili M, Ostadrahimi A, Hallajzadeh J, Ebrahimzadeh-Attari V, Saghafi-Asl M. Nutritional management of diabetes mellitus during the pandemic of COVID-19: a comprehensive narrative review. J Diabetes Metab Disord 2021; 20:963-972. [PMID: 33842400 PMCID: PMC8021300 DOI: 10.1007/s40200-021-00784-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 03/20/2021] [Indexed: 01/08/2023]
Abstract
Objectives According to the recent epidemiological studies, patients with diabetes mellitus (DM) may be at higher risk of hospitalization due to COVID-19. Regarding the important role of nutrition on the immunity, the present review article aimed to outline nutritional support of DM during the outbreak of COVID-19 with a mechanistic insight. Methods Searches were performed in PubMed/MEDLINE, ScienceDirect, Scopus, and Google Scholar databases from 2000 until December 2020 using the following keywords. All relevant clinical and experimental studies published in English were included. Results Evidences revealed that hyperglycemia is a significant predictor of some viral infections including COVID-19 which can exacerbate the complications of DM. According to the literature review, adequate intake of dietary protein, fiber, essential fatty acids and some micronutrients especially vitamins D, C, B12, folate, zinc and selenium has beneficial effects on the prevention and treatment of COVID-19 in diabetic patients through modulation of innate and adaptive immune responses or direct effects on virus enzymes or the rate of cell entrance. Conclusions It is well understood that malnutrition may increase susceptibility to viral infections and disease progression. Therefore, considering nutritional status of diabetic patients and reasonable supplementation of the above mentioned nutrients can ameliorate the symptoms of COVID-19 in DM. However, further well-designed clinical trials are needed to determine their therapeutic dose.
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Affiliation(s)
- Sepideh Mahluji
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsa Jalili
- Department of Biology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Alireza Ostadrahimi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Clinical Nutrition, Faculty of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jamal Hallajzadeh
- Department of Biochemistry, Maragheh University of Medical Sciences, Maragheh, Iran
| | | | - Maryam Saghafi-Asl
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Clinical Nutrition, Faculty of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Ebrahimzadeh-Attari V, Panahi G, Hebert JR, Ostadrahimi A, Saghafi-Asl M, Lotfi-Yaghin N, Baradaran B. Nutritional approach for increasing public health during pandemic of COVID-19: A comprehensive review of antiviral nutrients and nutraceuticals. Health Promot Perspect 2021; 11:119-136. [PMID: 34195036 PMCID: PMC8233676 DOI: 10.34172/hpp.2021.17] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 02/03/2021] [Indexed: 12/15/2022] Open
Abstract
Background: The novel coronavirus (COVID-19) is considered as the most life-threatening pandemic disease during the last decade. The individual nutritional status, though usually ignored in the management of COVID-19, plays a critical role in the immune function and pathogenesis of infection. Accordingly, the present review article aimed to report the effects of nutrients and nutraceuticals on respiratory viral infections including COVID-19, with a focus on their mechanisms of action. Methods: Studies were identified via systematic searches of the databases including PubMed/ MEDLINE, ScienceDirect, Scopus, and Google Scholar from 2000 until April 2020, using keywords. All relevant clinical and experimental studies published in English were included. Results: Protein-energy malnutrition (PEM) is common in severe respiratory infections and should be considered in the management of COVID-19 patients. On the other hand, obesity can be accompanied by decreasing the host immunity. Therefore, increasing physical activity at home and a slight caloric restriction with adequate intake of micronutrients and nutraceuticals are simple aids to boost host immunity and decrease the clinical manifestations of COVID-19. Conclusion: The most important nutrients which can be considered for COVID-19 management are vitamin D, vitamin C, vitamin A, folate, zinc, and probiotics. Their adequacy should be provided through dietary intake or appropriate supplementation. Moreover, adequate intake of some other dietary agents including vitamin E, magnesium, selenium, alpha linolenic acid and phytochemicals are required to maintain the host immunity.
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Affiliation(s)
| | - Ghodratollah Panahi
- Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - James R Hebert
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Alireza Ostadrahimi
- Nutrition Research Center, Department of Clinical Nutrition, Faculty of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Saghafi-Asl
- Nutrition Research Center, Department of Clinical Nutrition, Faculty of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Lotfi-Yaghin
- Student Research Committee, Department of Clinical Nutrition, Faculty of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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10
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Julio-Pieper M, López-Aguilera A, Eyzaguirre-Velásquez J, Olavarría-Ramírez L, Ibacache-Quiroga C, Bravo JA, Cruz G. Gut Susceptibility to Viral Invasion: Contributing Roles of Diet, Microbiota and Enteric Nervous System to Mucosal Barrier Preservation. Int J Mol Sci 2021; 22:ijms22094734. [PMID: 33946994 PMCID: PMC8125429 DOI: 10.3390/ijms22094734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 02/08/2023] Open
Abstract
The gastrointestinal lumen is a rich source of eukaryotic and prokaryotic viruses which, together with bacteria, fungi and other microorganisms comprise the gut microbiota. Pathogenic viruses inhabiting this niche have the potential to induce local as well as systemic complications; among them, the viral ability to disrupt the mucosal barrier is one mechanism associated with the promotion of diarrhea and tissue invasion. This review gathers recent evidence showing the contributing effects of diet, gut microbiota and the enteric nervous system to either support or impair the mucosal barrier in the context of viral attack.
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Affiliation(s)
- Marcela Julio-Pieper
- Grupo de NeuroGastroBioquímica, Instituto de Química, Facultad de Ciencias, Pontificia Universidad Católica de Valparaíso, Valparaíso 2340000, Chile; (A.L.-A.); (J.E.-V.); (J.A.B.)
- Correspondence:
| | - Alejandra López-Aguilera
- Grupo de NeuroGastroBioquímica, Instituto de Química, Facultad de Ciencias, Pontificia Universidad Católica de Valparaíso, Valparaíso 2340000, Chile; (A.L.-A.); (J.E.-V.); (J.A.B.)
| | - Johana Eyzaguirre-Velásquez
- Grupo de NeuroGastroBioquímica, Instituto de Química, Facultad de Ciencias, Pontificia Universidad Católica de Valparaíso, Valparaíso 2340000, Chile; (A.L.-A.); (J.E.-V.); (J.A.B.)
| | | | - Claudia Ibacache-Quiroga
- Centro de Micro-Bioinnovación (CMBi), Escuela de Nutrición y Dietética, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso 2340000, Chile;
| | - Javier A. Bravo
- Grupo de NeuroGastroBioquímica, Instituto de Química, Facultad de Ciencias, Pontificia Universidad Católica de Valparaíso, Valparaíso 2340000, Chile; (A.L.-A.); (J.E.-V.); (J.A.B.)
| | - Gonzalo Cruz
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2340000, Chile;
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11
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Kendall E, Millard A, Beaumont J. The "weanling's dilemma" revisited: Evolving bodies of evidence and the problem of infant paleodietary interpretation. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 175 Suppl 72:57-78. [PMID: 33460467 DOI: 10.1002/ajpa.24207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/23/2020] [Accepted: 12/06/2020] [Indexed: 01/02/2023]
Abstract
Breastfeeding is known to be a powerful mediator of maternal and childhood health, with impacts throughout the life course. Paleodietary studies of the past 30 years have accordingly taken an enduring interest in the health and diet of young children as a potential indicator of population fertility, subsistence, and mortality patterns. While progress has been made in recent decades toward acknowledging the agency of children, many paleodietary reconstructions have failed to incorporate developments in cognate disciplines revealing synergistic dynamics between maternal and offspring biology. Paleodietary interpretation has relied heavily on the "weanling's dilemma," in which infants are thought to face a bleak choice between loss of immunity or malnutrition. Using a review of immunological and epidemiological evidence for the dynamic and supportive role that breastfeeding plays throughout the complementary feeding period, this article offers context and nuance for understanding past feeding transitions. We suggest that future interpretative frameworks for infant paleodietary and bioarchaeological research should include a broad knowledge base that keeps pace with relevant developments outside of those disciplines.
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Affiliation(s)
- Ellen Kendall
- Department of Archaeology, Durham University, Durham, UK
| | - Andrew Millard
- Department of Archaeology, Durham University, Durham, UK
| | - Julia Beaumont
- School of Archaeological and Forensic Sciences, University of Bradford, Bradford, UK
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12
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Xue Z, Coughlin R, Amorosa V, Quinn R, Schiavone P, Stoner N, Kinosian B, Compher C. Factors Associated With Central Line-Associated Bloodstream Infections in a Cohort of Adult Home Parenteral Nutrition Patients. JPEN J Parenter Enteral Nutr 2020; 44:1388-1396. [PMID: 32386254 DOI: 10.1002/jpen.1876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 05/04/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Central line-associated bloodstream infection (CLABSI) is a potentially life-threatening complication in home parenteral nutrition (HPN) patients. We investigated potential predictors of CLABSI in a cohort of adult HPN patients METHODS: Patients managed by the HPN service at the Hospital of University of Pennsylvania on January 1, 2018, were included and followed through June 30, 2019, using existing medical records to collect demographic and clinical data. CLABSIs were adjudicated prospectively by infectious disease experts. Variables with P ≤ .2, when comparing patients with CLABSIs and those without, were included in logistic regression models. RESULTS Among 114 patients, mean age was 54 ± 16 years, 78/114 were female, and BMI was 25 ± 5.6. Median experience with HPN was 516 days (range, 15-10,281), and 30 had prior CLABSI. Catheter types were peripherally inserted central catheters (83/114), tunneled (27), and implanted (4). The incidence of CLABSI was 0.89 per 1000 catheter days. One multivariate model identified ostomy/wound (odds ratio [OR], 22.0; 95% CI, 4.8-101.7), tunneled/implanted catheter (OR, 4.4; 95% CI, 1.4-13.9), and BMI < 18.5 (OR, 5.9; 95% CI, 1.4-24.2) as predictors of CLABSI. A second model identified patients with 2 potential predictors (OR, 22.9; 95% CI, 5.6-93.5) and tunneled/implanted catheter (OR, 6.7; 95% CI, 2.1-21.8) at high risk of CLABSI. Whether CLABSIrates might be reduced by more intense training in wound or catheter care (especially for those with multiple predictors), different types of catheters, or rapid treatment of malnutrition will require further study.
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Affiliation(s)
- Zhigang Xue
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Valerianna Amorosa
- Penn Home Infusion Therapy, Philadelphia, Pennsylvania, USA.,University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Ryan Quinn
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Phyllis Schiavone
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nancy Stoner
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Bruce Kinosian
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Charlene Compher
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.,School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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13
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Li K, Li X, Si W, Cui Y, Xia H, Sun X, Song X, Liang H. Preoperative and operation-related risk factors for postoperative nosocomial infections in pediatric patients: A retrospective cohort study. PLoS One 2019; 14:e0225607. [PMID: 31869341 PMCID: PMC6927644 DOI: 10.1371/journal.pone.0225607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 11/07/2019] [Indexed: 12/02/2022] Open
Abstract
Background Pediatric patients undergoing invasive operations bear extra risk of developing nosocomial infections (NIs). However, epidemiological evidence of the underlying risk factors, which is needed for early prevention, remains limited. Methods Using data from the electronic medical records and the NI reporting system of a tertiary pediatric hospital, we conducted a retrospective analysis to identify preoperative and operation-related risk factors for postoperative NIs. Multivariable accelerated failure time models were fitted to select independent risk factors. The performance of these factors in risk stratification was examined by comparing the empirical risks between the model-defined low- and high-risk groups. Results A total of 18,314 children undergoing invasive operations were included for analysis. After a follow-up period of 154,700 patient-days, 847 postoperative NIs were diagnosed. The highest postoperative NI rate was observed for operations on hemic and lymphatic system. Surgical site infections were the NI type showing the highest overall risk; however, patients were more likely to develop urinary tract infections in the first postoperative week. Older age, higher weight-for-height z-score, longer preoperative ICU stay, preoperative enteral nutrition, same-day antibiotic prophylaxis, and higher hemoglobin level were associated with delayed occurrence of postoperative NIs, while longer preoperative hospitalization, longer operative duration, and higher American Society of Anesthesiologists score showed acceleration effects. Risk stratification based on these factors in an independent patient population was moderate, resulting in a high-risk group in which 72% of the postoperative NIs were included. Conclusions Our findings suggest that pediatric patients undergoing invasive operations and at high risk of developing postoperative NIs are likely to be identified using basic preoperative and operation-related risk factors, which together might lead to moderately accurate risk stratification but still provide valuable information to guide early and judicious prevention.
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Affiliation(s)
- Kuanrong Li
- Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiaojun Li
- Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Wenyue Si
- Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yanqin Cui
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Huimin Xia
- Guangdong Province Key Laboratory of Structural Birth Defects, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xin Sun
- Department of Medical Administration, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xingrong Song
- Department of Anesthesiology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Huiying Liang
- Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- * E-mail:
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14
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Kay A, Leidman E, Lopez V, Wilkinson C, Tondeur M, Bilukha O. The burden of anaemia among displaced women and children in refugee settings worldwide, 2013-2016. BMJ Glob Health 2019; 4:e001837. [PMID: 31798995 PMCID: PMC6861076 DOI: 10.1136/bmjgh-2019-001837] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/29/2019] [Accepted: 09/22/2019] [Indexed: 11/29/2022] Open
Abstract
Introduction Displaced persons have a unique risk for developing anaemia due to often limited diets, overcrowding, new infections and inadequate sanitation and hygiene. The lack of anaemia prevalence estimates among the displaced inhibit global planning for anaemia reduction. Methods We analysed population representative, cross-sectional nutrition surveys from 2013 to 2016 conducted by the United Nations High Commissioner for Refugees and partner agencies. Included surveys measured haemoglobin concentration among children 6–59 months, non-pregnant women 15–49 years, or both groups. For each survey, we calculated mean haemoglobin and prevalence of total anaemia (<110 g/L in children, <120 g/L in women), and classified public health severity following WHO guidelines. Pearson correlations between indicators from women and children surveys were calculated where both subpopulations were measured. Results Analysis included 196 surveys among children and 184 surveys among women from 121 unique refugee settings in 24 countries. The median prevalence of total anaemia in children and women was 44% and 28%, respectively. Sixty-one per cent of child surveys indicated a problem of severe public health importance compared with 25% of surveys in women. The prevalence of total anaemia in children and women was strongly correlated (ρ=0.80). Median prevalence of total anaemia was approximately 55% greater and mean haemoglobin was 6 g/L lower among children age 6–23 months compared with children 24–59 months. West and Central Africa region had the highest median prevalence of anaemia both in women and children. Conclusion While the burden of anaemia is high among the displaced, it mirrors that of the general population. Haemoglobin should continue to be measured in nutrition surveys in refugee settings. Sustained, multisectoral efforts to reduce anaemia are needed, with specific focus on children under 2 years of age and refugee settings in the West and Central Africa region.
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Affiliation(s)
- Ariel Kay
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Eva Leidman
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Velma Lopez
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Caroline Wilkinson
- Division of Programme Support and Management, Public Health Section, United Nations High Commissioner for Refugees, Geneva, Switzerland
| | - Melody Tondeur
- Division of Programme Support and Management, Public Health Section, United Nations High Commissioner for Refugees, Geneva, Switzerland
| | - Oleg Bilukha
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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15
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Sinha S, Patro N, Patro IK. Maternal Protein Malnutrition: Current and Future Perspectives of Spirulina Supplementation in Neuroprotection. Front Neurosci 2018; 12:966. [PMID: 30618587 PMCID: PMC6305321 DOI: 10.3389/fnins.2018.00966] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/03/2018] [Indexed: 12/30/2022] Open
Abstract
Malnutrition has been widely recognized as a grave burden restricting the progress of underdeveloped and developing countries. Maternal, neonatal and postnatal nutritional immunity provides an effective approach to decrease the risk of malnutrition associated stress in adulthood. Particularly, maternal nutritional status is a critical contributor for determining the long-term health aspects of an offspring. Maternal malnutrition leads to increased risk of life, poor immune system, delayed motor development and cognitive dysfunction in the children. An effective immunomodulatory intervention using nutraceutical could be used to enhance immunity against infections. The immune system in early life possesses enormous dynamic capacity to manage both genetic and environment driven processes and can adapt to rapidly changing environmental exposures. These immunomodulatory stimuli or potent nutraceutical strategy can make use of early life plasticity to target pathways of immune ontogeny, which in turn could increase the immunity against infectious diseases arising from malnutrition. This review provides appreciable human and animal data showing enduring effects of protein deprivation on CNS development, oxidative stress and inflammation and associated behavioral and cognitive impairments. Relevant studies on nutritional supplementation and rehabilitation using Spirulina as a potent protein source and neuroprotectant against protein malnutrition (PMN) induced deleterious changes have also been discussed. However, there are many futuristic issues that need to be resolved for proper modulation of these therapeutic interventions to prevent malnutrition.
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Affiliation(s)
- Shrstha Sinha
- School of Studies in Neuroscience, Jiwaji University, Gwalior, India.,School of Studies in Zoology, Jiwaji University, Gwalior, India
| | - Nisha Patro
- School of Studies in Neuroscience, Jiwaji University, Gwalior, India
| | - Ishan K Patro
- School of Studies in Neuroscience, Jiwaji University, Gwalior, India.,School of Studies in Zoology, Jiwaji University, Gwalior, India
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16
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Ives R, Humphrey L. Endochondral growth disruption during vitamin D deficiency rickets in a mid-19th century series from Bethnal Green, London, UK. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 167:585-601. [DOI: 10.1002/ajpa.23687] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/23/2018] [Accepted: 07/02/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Rachel Ives
- Department of Earth Sciences; Natural History Museum; London The United Kingdom
- AOC Archaeology Group; Twickenham The United Kingdom
| | - Louise Humphrey
- Department of Earth Sciences; Natural History Museum; London The United Kingdom
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17
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Calatayud FM, Calatayud B, Gallego JG, González-Martín C, Alguacil LF. Effects of Mediterranean diet in patients with recurring colds and frequent complications. Allergol Immunopathol (Madr) 2017; 45:417-424. [PMID: 27939720 DOI: 10.1016/j.aller.2016.08.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/29/2016] [Accepted: 08/19/2016] [Indexed: 12/18/2022]
Abstract
INTRODUCTION In recent years, traditional diets enriched with fresh plant-based foods have been gradually abandoned, increasing the consumption of animal foods and highly processed food. The aim of this study was to assess the effects of a nutritional intervention with a Traditional Mediterranean Diet in patients with recurring colds (RC) and frequent inflammatory complications (IC). METHODS Prospective before-after comparison study of 63 girls and 65 boys aged 1-5 years were included over a year in the nutritional programme "Learning to eat from the Mediterranean". We studied clinical and therapeutic variables and various anthropometric parameters. RESULTS All the studied indicators (number of catarrhal episodes CB, degree of intensity, emergency and hospital admissions) showed a positive and statistically significant evolution, evidenced from the first weeks of starting treatment, until the end of the year, after which 53.9% of patients had no CB, 25% had only one, and 16.4% had two episodes, compared to the 4.64 episodes on average in the previous year. Antibiotic use decreased by 87.4%, from 3.85±1.27 times/patient/year to 0.49±0.79 (p<0.001). Symptomatic treatment decreased by 56.7%, from 7.03±2.76 to 3.05±1.69 (p<0.001). The satisfaction of the families was very high. The Kidmed index, which assesses the quality of the Mediterranean Diet, increased from 7.8 to 10.9 points. CONCLUSION The adoption of a Traditional Mediterranean Diet could be a major contribution to the improvement of patients with recurring colds and frequent inflammatory complications.
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Affiliation(s)
- F M Calatayud
- Pediatra en Clínica infanto-juvenil "La Palma", C/Palma 17, bajo A, Ciudad Real, DP: 13001, Spain.
| | - B Calatayud
- Nutricionista en Clínica infanto-juvenil "La Palma", C/Palma 17, bajo A, Ciudad Real, DP: 13001, Spain
| | - J G Gallego
- Médico de familia en Centro de Salud n° 1 de Ciudad Real, Plaza de la Provincia 4, 3° A, Ciudad Real, DP: 13001, Spain
| | - C González-Martín
- Profesora de Toxicología, Universidad CEU San Pablo, Madrid, Urb. Montepríncipe, Boadilla, DP: 28668, Spain
| | - L F Alguacil
- Catedrático de Farmacología, Universidad CEU San Pablo, Madrid, Urb. Montepríncipe, Boadilla, DP: 28668, Spain
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18
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Ives R, Humphrey L. Patterns of long bone growth in a mid-19th century documented sample of the urban poor from Bethnal Green, London, UK. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2017; 163:173-186. [DOI: 10.1002/ajpa.23198] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/09/2017] [Accepted: 02/13/2017] [Indexed: 01/03/2023]
Affiliation(s)
- Rachel Ives
- Department of Earth Sciences; Natural History Museum; London SW7 5BD United Kingdom
- AOC Archaeology Group; Twickenham TW1 1JS United Kingdom
| | - Louise Humphrey
- Department of Earth Sciences; Natural History Museum; London SW7 5BD United Kingdom
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19
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Akombi BJ, Agho KE, Hall JJ, Merom D, Astell-Burt T, Renzaho AMN. Stunting and severe stunting among children under-5 years in Nigeria: A multilevel analysis. BMC Pediatr 2017; 17:15. [PMID: 28086835 PMCID: PMC5237247 DOI: 10.1186/s12887-016-0770-z] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 12/30/2016] [Indexed: 11/13/2022] Open
Abstract
Background Stunting has been identified as one of the major proximal risk factors for poor physical and mental development of children under-5 years. Stunting predominantly occurs in the first 1000 days of life (0–23 months) and continues to the age of five. This study examines factors associated with stunting and severe stunting among children under-5 years in Nigeria. Methods The sample included 24,529 children aged 0–59 months from the 2013 Nigeria Demographic and Health Survey (NDHS). Height-for-age z-scores (HFAz), generated using the 2006 World Health Organisation (WHO) growth reference, were used to define stunting (HFAz < −2SD) and severe stunting (HFAz < −3SD). Multilevel logistic regression analyses that adjusted for cluster and survey weights were used to determine potential risk factors associated with stunting and severe stunting among children under-5 years in Nigeria. Results The prevalence of stunting and severe stunting were 29% [95% Confidence interval (Cl): 27.4, 30.8] and 16.4% [95%Cl: 15.1, 17.8], respectively for children aged 0–23 months, and 36.7% [95%Cl: 35.1, 38.3] and 21% [95%Cl: 19.7, 22.4], respectively for children aged 0–59 months. Multivariate analysis revealed that the most consistent significant risk factors for stunting and severe stunting among children aged 0–23 months and 0–59 months are: sex of child (male), mother’s perceived birth size (small and average), household wealth index (poor and poorest households), duration of breastfeeding (more than 12 months), geopolitical zone (North East, North West, North Central) and children who were reported to having had diarrhoea in the 2 weeks prior to the survey [Adjusted odds ratio (AOR) for stunted children 0–23 months = 1.22 (95%Cl: 0.99, 1.49)];[AOR for stunted children 0–59 months = 1.31 (95%Cl: 1.16, 1.49)], [AOR for severely stunted children 0–23 months = 1.31 (95%Cl: 1.03, 1.67)]; [AOR for severely stunted children 0–59 months = 1.58 (95%Cl: 1.38, 1.82)]. Conclusions In order to meet the post-2015 sustainable development goals, policy interventions to reduce stunting in Nigeria should focus on poverty alleviation as well as improving women’s nutrition, child feeding practices and household sanitation.
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Affiliation(s)
- Blessing Jaka Akombi
- School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2571, Australia.
| | - Kingsley Emwinyore Agho
- School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2571, Australia
| | - John Joseph Hall
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Dafna Merom
- School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2571, Australia
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab) School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia.,Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, 2522, Australia
| | - Andre M N Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
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20
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Lambert C, Nüssler A, Biesalski HK, Freude T, Bahrs C, Ochs G, Flesch I, Stöckle U, Ihle C. Age-dependent risk factors for malnutrition in traumatology and orthopedic patients. Nutrition 2017; 37:60-67. [PMID: 28359364 DOI: 10.1016/j.nut.2016.12.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/25/2016] [Accepted: 12/18/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the prevalence of risk of malnutrition (RoM) in an orthopedic and traumatology patient cohort with a broad range of ages. In addition to the classical indicators for risk assessment (low body mass index, weight loss, and comorbidity), this study aimed to analyze the effects of lifestyle factors (eating pattern, smoking, physical activity) on RoM. METHODS The prospective cohort study included 1053 patients in a level 1 trauma center in Germany. RoM was assessed by Nutritional Risk Screening (NRS) 2002 and for the elderly additionally by Mini Nutritional Assessment (MNA). Age-dependent risk factors identified in univariate statistical analysis were used for multivariate logistic regression models. RESULTS The prevalence of patients at RoM (NRS ≥3) was 22%. In the three age categories (<50 y, 50-69 y, and ≥70 y), loss of appetite, weight loss, number of comorbidities, drugs and gastrointestinal symptoms significantly increased RoM in univariate statistical analysis. In patients ages ≥70 y, several disease- and lifestyle-related factors (not living at home, less frequent consumption of vegetables and whole meal bread, low physical activity, and smoking) were associated with RoM. Multivariate logistic regression model for the total study population identified weight loss (odds ratio [OR], 6.09; 95% confidence interval [CI], 4.14-8.83), loss of appetite (OR, 3.81; 95% CI, 2.52-5.78), age-specific low BMI (OR, 1.87; 95% CI, 1.18-2.97), number of drugs taken (OR, 1.19; 95% CI, 1.12-1.26), age (OR, 1.03; 95% CI, 1.02-1.04), and days per week with vegetable consumption (OR, 0.938; 95% CI, 0.89-0.99) as risk factors. CONCLUSION Malnutrition in trauma and orthopedic patients is not only a problem related to age. Lifestyle-related factors also contribute significantly to malnutrition in geriatric patients.
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Affiliation(s)
- Christine Lambert
- Institute of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany.
| | - Andreas Nüssler
- Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Hans Konrad Biesalski
- Institute of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany
| | - Thomas Freude
- Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Christian Bahrs
- Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Gunnar Ochs
- Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Ingo Flesch
- Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Ulrich Stöckle
- Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Christoph Ihle
- Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
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Christensen RAG, Raiber L, Macpherson AK, Kuk JL. The association between obesity and self-reported sinus infection in non-smoking adults: a cross-sectional study. Clin Obes 2016; 6:389-394. [PMID: 27860347 DOI: 10.1111/cob.12164] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/07/2016] [Accepted: 09/26/2016] [Indexed: 11/29/2022]
Abstract
The aim of this article was to examine the associations between having had a sinus infection (SI) and BMI and physical activity (PA), diet quality, stress and/or sleep. A total of 2915 adults from the National Health and Nutrition Examination Survey 2005-2006 were examined. Logistic regression analysis was used to examine the association between having had an SI with BMI and PA, diet quality, stress or sleep. As these factors are known to influence one another, a fully adjusted model with PA, diet quality, stress and sleep was also constructed to examine their independent associations with having had an SI. Overall, 15.5 ± 1.2% of the population report having had an SI in the past year. In all models, individuals with obesity were approximately twice as likely to have had an SI compared to those of normal weight (P < 0.05). While PA and diet quality were not significantly associated with having had an SI (P > 0.05), individuals with stress and sleep troubles were also twice as likely to have had an SI (P < 0.05) independent of BMI. In the fully adjusted model, only the associations for BMI and sleep troubles remained significant (P < 0.05). Results from this study suggest that obesity and sleep troubles, but not PA, quality of diet and stress, are associated with having had an SI. As interactions exist between obesity, immune system factors and exposure to infectious disease(s), more research is necessary to understand the directionality of these relationships.
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Affiliation(s)
- R A G Christensen
- Department of Kinesiology and Health Science, York University, Toronto, Canada
| | - L Raiber
- Department of Kinesiology and Health Science, York University, Toronto, Canada
| | - A K Macpherson
- Department of Kinesiology and Health Science, York University, Toronto, Canada
| | - J L Kuk
- Department of Kinesiology and Health Science, York University, Toronto, Canada
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de Onis M, Branca F. Childhood stunting: a global perspective. MATERNAL & CHILD NUTRITION 2016; 12 Suppl 1:12-26. [PMID: 27187907 PMCID: PMC5084763 DOI: 10.1111/mcn.12231] [Citation(s) in RCA: 555] [Impact Index Per Article: 69.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 08/28/2015] [Accepted: 09/09/2015] [Indexed: 12/25/2022]
Abstract
Childhood stunting is the best overall indicator of children's well-being and an accurate reflection of social inequalities. Stunting is the most prevalent form of child malnutrition with an estimated 161 million children worldwide in 2013 falling below -2 SD from the length-for-age/height-for-age World Health Organization Child Growth Standards median. Many more millions suffer from some degree of growth faltering as the entire length-for-age/height-for-age z-score distribution is shifted to the left indicating that all children, and not only those falling below a specific cutoff, are affected. Despite global consensus on how to define and measure it, stunting often goes unrecognized in communities where short stature is the norm as linear growth is not routinely assessed in primary health care settings and it is difficult to visually recognize it. Growth faltering often begins in utero and continues for at least the first 2 years of post-natal life. Linear growth failure serves as a marker of multiple pathological disorders associated with increased morbidity and mortality, loss of physical growth potential, reduced neurodevelopmental and cognitive function and an elevated risk of chronic disease in adulthood. The severe irreversible physical and neurocognitive damage that accompanies stunted growth poses a major threat to human development. Increased awareness of stunting's magnitude and devastating consequences has resulted in its being identified as a major global health priority and the focus of international attention at the highest levels with global targets set for 2025 and beyond. The challenge is to prevent linear growth failure while keeping child overweight and obesity at bay.
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Affiliation(s)
- Mercedes de Onis
- Department of Nutrition for Health and DevelopmentWorld Health OrganizationGenevaSwitzerland
| | - Francesco Branca
- Department of Nutrition for Health and DevelopmentWorld Health OrganizationGenevaSwitzerland
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Wham C, Baggett F, Teh R, Moyes S, Kēpa M, Connolly M, Jatrana S, Kerse N. Dietary protein intake may reduce hospitalisation due to infection in Māori of advanced age: LiLACS NZ. Aust N Z J Public Health 2015; 39:390-5. [DOI: 10.1111/1753-6405.12406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 01/01/2015] [Accepted: 02/01/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- Carol Wham
- School of Food and Nutrition; Massey University; New Zealand
| | - Fiona Baggett
- School of Food and Nutrition; Massey University; New Zealand
| | - Ruth Teh
- Department of General Practice and Primary Health Care; University of Auckland; New Zealand
| | - Simon Moyes
- Department of General Practice and Primary Health Care; University of Auckland; New Zealand
| | - Mere Kēpa
- Department of General Practice and Primary Health Care; University of Auckland; New Zealand
| | - Martin Connolly
- Freemason's Department of Geriatric Medicine; North Shore, University of Auckland; New Zealand
| | - Santosh Jatrana
- Alfred Deakin Research Institute, Deakin University; Victoria
| | - Ngaire Kerse
- Department of General Practice and Primary Health Care; University of Auckland; New Zealand
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Bresnahan KA, Tanumihardjo SA. Undernutrition, the acute phase response to infection, and its effects on micronutrient status indicators. Adv Nutr 2014; 5:702-11. [PMID: 25398733 PMCID: PMC4224207 DOI: 10.3945/an.114.006361] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Infection and undernutrition are prevalent in developing countries and demonstrate a synergistic relation. Undernutrition increases infection-related morbidity and mortality. The acute phase response (APR) is an innate, systemic inflammatory reaction to a wide array of disruptions in a host's homeostasis, including infection. Released from immune cells in response to deleterious stimuli, proinflammatory cytokines act on distant tissues to induce behavioral (e.g., anorexia, weakness, and fatigue) and systemic effects of the APR. Cytokines act to increase energy and protein requirements to manifest fever and support hepatic acute phase protein (APP) production. Blood concentrations of glucose and lipid are augmented to provide energy to immune cells in response to cytokines. Additionally, infection decreases intestinal absorption of nutrients and can cause direct loss of micronutrients. Traditional indicators of iron, zinc, and vitamin A status are altered during the APR, leading to inaccurate estimations of deficiency in populations with a high or unknown prevalence of infection. Blood concentrations of APPs can be measured in nutrition interventions to assess the time stage and severity of infection and correct for the APR; however, standardized cutoffs for nutrition applications are needed. Protein-energy malnutrition leads to increased gut permeability to pathogens, abnormal immune cell populations, and impaired APP response. Micronutrient deficiencies cause specific immune impairments that affect both innate and adaptive responses. This review describes the antagonistic interaction between the APR and nutritional status and emphasizes the need for integrated interventions to address undernutrition and to reduce disease burden in developing countries.
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Bresnahan KA, Chileshe J, Arscott S, Nuss E, Surles R, Masi C, Kafwembe E, Tanumihardjo SA. The acute phase response affected traditional measures of micronutrient status in rural Zambian children during a randomized, controlled feeding trial. J Nutr 2014; 144:972-8. [PMID: 24717369 DOI: 10.3945/jn.114.192245] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The acute phase response (APR) to infection can alter blood-based indicators of micronutrient status. Data from a 3-mo randomized, controlled feeding trial in rural Zambian children (n = 181, aged 3-5 y) were used to determine the impact of the APR on indicators of vitamin A and iron status using baseline and final blood samples. Concentrations of acute phase proteins were categorized as raised C-reactive protein (CRP; >5 and >10 mg/L) only, both raised CRP and α1-acid glycoprotein (AGP; >1.2 g/L), raised AGP only, and neither CRP nor AGP raised to identify the respective stages of infection: incubation, early convalescence, convalescence, and healthy state. Data were insufficient to examine the incubation stage of infection. A CRP concentration of >5 mg/L was an effective elevation cutoff point in this population to show impact on micronutrient markers. Time did not affect hemoglobin, serum ferritin, or serum retinol concentrations (P > 0.05). During early convalescence, hemoglobin decreased (14-16%; P ≤ 0.05), serum ferritin increased (279-356%; P ≤ 0.05), and serum retinol decreased (20-30%; P ≤ 0.05). Serum retinol concentrations did not change during convalescence; however, hemoglobin remained depressed (4-9%) and serum ferritin was elevated (67-132%) (both P ≤ 0.05). Modified relative dose response values were unaffected by the APR (P > 0.05) but increased between time points (16%; P ≤ 0.05), indicating a decrease in liver vitamin A reserves on the background of a semiannual vitamin A supplementation program. The observed prevalence of anemia and vitamin A deficiency assessed by serum retinol concentration was higher during the APR (P ≤ 0.05). It is important to consider the impact of infection on dietary interventions and to adjust for acute phase proteins when assessing iron status or vitamin A status by serum retinol concentration alone in children.
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Affiliation(s)
- Kara A Bresnahan
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
| | | | - Sara Arscott
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
| | - Emily Nuss
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
| | - Rebecca Surles
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
| | - Cassim Masi
- National Food and Nutrition Commission of Zambia, Lusaka, Zambia
| | | | - Sherry A Tanumihardjo
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
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Stewart CP, Iannotti L, Dewey KG, Michaelsen KF, Onyango AW. Contextualising complementary feeding in a broader framework for stunting prevention. MATERNAL & CHILD NUTRITION 2013; 9 Suppl 2:27-45. [PMID: 24074316 PMCID: PMC6860787 DOI: 10.1111/mcn.12088] [Citation(s) in RCA: 322] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
An estimated 165 million children are stunted due to the combined effects of poor nutrition, repeated infection and inadequate psychosocial stimulation. The complementary feeding period, generally corresponding to age 6-24 months, represents an important period of sensitivity to stunting with lifelong, possibly irrevocable consequences. Interventions to improve complementary feeding practices or the nutritional quality of complementary foods must take into consideration the contextual as well as proximal determinants of stunting. This review presents a conceptual framework that highlights the role of complementary feeding within the layers of contextual and causal factors that lead to stunted growth and development and the resulting short- and long-term consequences. Contextual factors are organized into the following groups: political economy; health and health care systems; education; society and culture; agriculture and food systems; and water, sanitation and environment. We argue that these community and societal conditions underlie infant and young child feeding practices, which are a central pillar to healthy growth and development, and can serve to either impede or enable progress. Effectiveness studies with a strong process evaluation component are needed to identify transdisciplinary solutions. Programme and policy interventions aimed at preventing stunting should be informed by careful assessment of these factors at all levels.
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Affiliation(s)
- Christine P. Stewart
- Program in International and Community Nutrition, Department of NutritionUniversity of CaliforniaDavisCA
| | - Lora Iannotti
- Institute for Public Health, George Warren Brown School of Social WorkWashington University in St. LouisMOUSA
| | - Kathryn G. Dewey
- Program in International and Community Nutrition, Department of NutritionUniversity of CaliforniaDavisCA
| | - Kim F. Michaelsen
- Department of Human Nutrition, Faculty of Life SciencesUniversity of CopenhagenFrederiksbergDenmark
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Wells JCK, Cortina-Borja M. Different associations of subscapular and triceps skinfold thicknesses with pathogen load: an ecogeographical analysis. Am J Hum Biol 2013; 25:594-605. [PMID: 23913438 DOI: 10.1002/ajhb.22418] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Revised: 04/29/2013] [Accepted: 05/24/2013] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The dominant evolutionary perspective on adipose tissue has considered it a relatively inert energy store. However, variability in adipose tissue distribution has recently been associated with age, parity, thermal environment and immune function. Genes regulating the innate immune system are more strongly expressed in deep-lying than peripheral adipose tissue. We hypothesized that central adiposity would correlate more strongly than peripheral adiposity with pathogen load across populations. METHODS Primary outcomes were subscapular and triceps skinfolds from 133 male and 106 female populations. National values for disability-adjusted life years lost, attributable to infectious diseases, were used to index pathogen load. Linear mixed-effects models were fitted, including a random effect term by country to investigate the association of each skinfold with pathogen load, adjusting for the other skinfold, mean annual temperature and clustering of the populations across countries. RESULTS Adjusting for subscapular skinfold, triceps skinfold was not associated with pathogen load in either sex. Adjusting for triceps skinfold, subscapular skinfold was negatively associated with pathogen load in both sexes (P < 0.02). These associations were independent of variability in annual temperature. Adjusting for pathogen load and temperature, Oceanic populations had a different fat distribution compared to other populations. CONCLUSIONS Across populations, higher pathogen load was associated with reduced central but not peripheral skinfolds, supporting the hypothesis that central adiposity is more closely associated with immune function. This scenario might explain why some populations increase disproportionately in central adiposity when the environment shifts from low-energy high-pathogen status to high-energy low-pathogen status.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, United Kingdom
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Horta BL, Santos RV, Welch JR, Cardoso AM, dos Santos JV, Assis AMO, Lira PCI, Coimbra Jr CEA. Nutritional status of indigenous children: findings from the First National Survey of Indigenous People's Health and Nutrition in Brazil. Int J Equity Health 2013; 12:23. [PMID: 23552397 PMCID: PMC3637628 DOI: 10.1186/1475-9276-12-23] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 03/26/2013] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The prevalence of undernutrition, which is closely associated with socioeconomic and sanitation conditions, is often higher among indigenous than non-indigenous children in many countries. In Brazil, in spite of overall reductions in the prevalence of undernutrition in recent decades, the nutritional situation of indigenous children remains worrying. The First National Survey of Indigenous People's Health and Nutrition in Brazil, conducted in 2008-2009, was the first study to evaluate a nationwide representative sample of indigenous peoples. This paper presents findings from this study on the nutritional status of indigenous children < 5 years of age in Brazil. METHODS A multi-stage sampling was employed to obtain a representative sample of the indigenous population residing in villages in four Brazilian regions (North, Northeast, Central-West, and Southeast/South). Initially, a stratified probabilistic sampling was carried out for indigenous villages located in these regions. Households in sampled villages were selected by census or systematic sampling depending on the village population. The survey evaluated the health and nutritional status of children < 5 years, in addition to interviewing mothers or caretakers. RESULTS Height and weight measurements were taken of 6,050 and 6,075 children, respectively. Prevalence rates of stunting, underweight, and wasting were 25.7%, 5.9%, and 1.3%, respectively. Even after controlling for confounding, the prevalence rates of underweight and stunting were higher among children in the North region, in low socioeconomic status households, in households with poorer sanitary conditions, with anemic mothers, with low birthweight, and who were hospitalized during the prior 6 months. A protective effect of breastfeeding for underweight was observed for children under 12 months. CONCLUSIONS The elevated rate of stunting observed in indigenous children approximates that of non-indigenous Brazilians four decades ago, before major health reforms greatly reduced its occurrence nationwide. Prevalence rates of undernutrition were associated with socioeconomic variables including income, household goods, schooling, and access to sanitation services, among other variables. Providing important baseline data for future comparison, these findings further suggest the relevance of social, economic, and environmental factors at different scales (local, regional, and national) for the nutritional status of indigenous peoples.
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Affiliation(s)
- Bernardo L Horta
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS, 96020-220, Brazil
| | - Ricardo Ventura Santos
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, 21041-210, Brazil
- Departamento de Antropologia, Museu Nacional, Universidade Federal do Rio de Janeiro, Quinta da Boa Vista s/n, Rio de Janeiro, RJ, 20940-040, Brazil
| | - James R Welch
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Andrey M Cardoso
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Janaína Vieira dos Santos
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS, 96020-220, Brazil
| | | | - Pedro CI Lira
- Departamento de Nutrição, Universidade Federal de Pernambuco, Avenida Professor Moraes Rego 1235, Recife, PE, 50670-901, Brazil
| | - Carlos EA Coimbra Jr
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, 21041-210, Brazil
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Hall A, Zhang Y, MacArthur C, Baker S. The role of nutrition in integrated programs to control neglected tropical diseases. BMC Med 2012; 10:41. [PMID: 22533927 PMCID: PMC3378428 DOI: 10.1186/1741-7015-10-41] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 04/25/2012] [Indexed: 01/16/2023] Open
Abstract
There are strong and direct relationships between undernutrition and the disease caused by infectious organisms, including the diverse pathogens labeled as neglected tropical diseases (NTDs). Undernutrition increases the risk of infection, the severity of disease and the risk that children will die, while the physical damage, loss of appetite, and host responses during chronic infection can contribute substantially to undernutrition. These relationships are often synergistic. This opinion article examines the role of nutrition in controlling NTDs and makes the point that mass drug treatment--the major strategy currently proposed to control several diseases--is crucial to controlling disease and transmission, but is only the start of the process of physical recovery. Without adequate energy and nutrients to repair damaged tissues or recover lost growth and development, the benefits of treatment may not be evident quickly; the effects of control programs may be not appreciated by beneficiaries; while vulnerability to reinfection and disease may not be reduced. There is substantial potential for nutritional interventions to be added to large-scale programs to deliver drug treatments and thereby contribute, within a broad strategy of public health interventions and behavior change activities, to controlling and preventing NTDs in populations, and to restoring their health.
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Affiliation(s)
- Andrew Hall
- Centre for Public Health Nutrition, School of Life Sciences, University of Westminster, 115 New Cavendish Street, London W1W 6UW, UK
| | - Yaobi Zhang
- Helen Keller International, Regional Office for Africa, BP 29.898, Dakar-Yoff, Senegal
| | - Chad MacArthur
- Helen Keller International, 352 Park Avenue South, New York, New York 10010, USA
| | - Shawn Baker
- Helen Keller International, Regional Office for Africa, BP 29.898, Dakar-Yoff, Senegal
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Restoration of anthropometric, biochemical and histopathological alterations by Lactobacillus casei supplementation in Giardia intestinalis infected renourished BALB/c mice. Antonie van Leeuwenhoek 2012; 102:61-72. [PMID: 22382675 DOI: 10.1007/s10482-012-9713-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Accepted: 02/16/2012] [Indexed: 01/05/2023]
Abstract
The present study describes the in vivo ameliorating effect of Lactobacillus casei supplementation in renourished Giardia intestinalis infected BALB/c mice. It was observed that daily administration of probiotic 7 days prior to Giardia-infection to renourished mice, efficiently reduced the excretion of Giardia cysts and trophozoite counts, along with significant increased fecal lactobacilli counts compared with Giardia-infected mice. It was also observed that oral feeding of probiotic to renourished-Giardia-infected mice abrogated all the anthropometric and biochemical anomalies. Histologically, morphological and cellular alteration of microvillus membrane integrity revealed that probiotic administration further ameliorated the mucosal damage in renourished-probiotic-Giardia-infected mice compared to severe microvillus atrophy, oedematous, vacuolated epithelial cells and ileitis in renourished-Giardia and Giardia-infected mice. Thus, it is suggested that probiotic used as the functional food helps in restoration of anthropometric, biochemical alterations and atrophied gut by enhancing the goblet cells and reducing the giardiasis.
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Botella H, Stadthagen G, Lugo-Villarino G, de Chastellier C, Neyrolles O. Metallobiology of host-pathogen interactions: an intoxicating new insight. Trends Microbiol 2012; 20:106-12. [PMID: 22305804 DOI: 10.1016/j.tim.2012.01.005] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 01/05/2012] [Accepted: 01/06/2012] [Indexed: 10/14/2022]
Abstract
Iron, zinc and copper, among others, are transition metals with multiple biological roles that make them essential elements for life. Beyond the strict requirement of transition metals by the vertebrate immune system for its proper functioning, novel mechanisms involving direct metal intoxication of microorganisms are starting to be unveiled as important components of the immune system, in particular against Mycobacterium tuberculosis. In parallel, metal detoxification systems in bacteria have been recently characterized as crucial microbial virulence determinants. Here, we will focus on these exciting advancements implicating copper- and zinc-mediated microbial poisoning as a novel innate immune mechanism against microbial pathogens, shedding light on an emerging field in the metallobiology of host-pathogen interactions.
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Affiliation(s)
- Hélène Botella
- Centre National de la Recherche Scientifique (CNRS), Institut de Pharmacologie et de Biologie Structurale (IPBS), BP 64182, F-31077 Toulouse, France
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Weisstaub G, Uauy R. Non-Breast Milk Feeding in Developing Countries: Challenge from Microbial and Chemical Contaminants. ANNALS OF NUTRITION AND METABOLISM 2012; 60:215-9. [DOI: 10.1159/000338203] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
AbstractThe present study was designed to delineate the effect of Giardia duodenalis in malnourished and renourished BALB/c mice. Control and renourished mice were fed with a standard pellet diet while malnourished mice were fed with a low protein (4.3 %) diet both before and after being challenged orally with actively growing G. duodenalis trophozoites. It was observed that malnourished mice had a greater severity and longer duration of Giardia infection compared with renourished mice. These malnourished mice also had less body mass but higher cyst and trophozoite counts. Malnourished mice infected with Giardia had significantly decreased level of total serum proteins, albumin, globulins, hemoglobin, leukocyte, and differential leukocyte counts compared with renourished mice. From the data it is concluded that protein malnutrition profoundly affects the anthropometric and physiological parameters of the body indicating greater susceptibility and severity of the disease.
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The effects of micronutrient-fortified complementary/replacement food on intestinal permeability and systemic markers of inflammation among maternally HIV-exposed and unexposed Zambian infants. Br J Nutr 2011; 107:893-902. [PMID: 21899803 DOI: 10.1017/s0007114511003734] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The present randomised trial investigated the effects of feeding Zambian infants from 6 to 18 months old either a richly or basal micronutrient-fortified complementary/replacement food on gut integrity and systemic inflammation. Blood samples were obtained from all infants (n 743) at 6 and 18 months for the assessment of serum C-reactive protein (CRP) and α1-acid glycoprotein (AGP). A subsample of 502 infants, selected from the main cohort to include a larger proportion of infants with HIV-positive mothers, was assigned to lactulose/mannitol gut permeability tests. Lactulose:mannitol (L:M) ratio analyses were adjusted for baseline urinary L:M ratio, socio-economic status, mother's education, season of birth and baseline stunting, and stratified by maternal antenatal HIV status, child's sex, concurrent breast-feeding status and anaemia at baseline. There was no significant difference in geometric mean L:M ratio between the richly fortified and basal-fortified porridge arms at 12 months (0·47 (95 % CI 0·41, 0·55) v. 0·41 (95 % CI 0·34, 0·49); P = 0·16 adjusted). At 18 months, the richly fortified porridge group had a significantly higher geometric mean L:M ratio than the basal-fortified group (0·23 (95 % CI 0·19, 0·28) v. 0·15 (95 % CI 0·12, 0·19); P = 0·02 adjusted). This effect was evident for all stratifications, significantly among boys (P = 0·04), among the infants of HIV-negative mothers (P = 0·01), among the infants of HIV-negative mothers not concurrently breast-fed (P = 0·01) and among those who were not anaemic at baseline (P = 0·03). CRP, but not AGP, was positively associated with L:M ratio, but there were no significant effects of the diet on either CRP or AGP. In conclusion, a richly fortified complementary/replacement food did not benefit and may have worsened intestinal permeability.
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Nützenadel W. Failure to thrive in childhood. DEUTSCHES ARZTEBLATT INTERNATIONAL 2011; 108:642-9. [PMID: 22025931 PMCID: PMC3198227 DOI: 10.3238/arztebl.2011.0642] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Accepted: 12/28/2010] [Indexed: 11/27/2022]
Abstract
BACKGROUND Failure to thrive impairs children's weight gain and growth, their defenses against infection, and their psychomotor and intellectual development. METHODS This paper is a review of pertinent articles that were published from 1995 to October 2010 and contained the terms "failure to thrive", "underweight", "malnutrition", "malabsorption", "maldigestion" and "refeeding syndrome". The articles were retrieved by a search in the PubMed and Cochrane Library databases. RESULTS In developed countries, failure to thrive is usually due to an underlying disease. The degree of malnutrition is assessed with anthropometric techniques. For each patient, the underlying disease must be identified and the mechanism of failure to thrive understood, so that proper medical and nutritional treatment can be provided. Nutritional treatment involves either giving more food, or else raising the caloric density of the patient's food. Liquid formulas can be given as a supplement to normal meals or as balanced or unbalanced tube feeds; they can be given orally, through a nasogastric tube, or through a gastrostomy tube. Severely malnourished children with poor oral intake should be treated with parenteral nutrition. To avoid refeeding syndrome in severely malnourished children, food intake should be increased slowly at first, and phosphate, magnesium, and potassium supplements should be given. CONCLUSION The proper treatment of failure to thrive in childhood consists of treatment of the underlying illness, combined with nutritional treatment that addresses the mechanism of the accompanying failure to thrive.
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Affiliation(s)
- Walter Nützenadel
- Klinikum Mannheim GmbH, Universitätsklinikum, Klinik für Kinder- und Jugendmedizin.
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Aaron GJ, Kariger P, Aliyu R, Flach M, Iya D, Obadiah M, Baker SK. A multi-micronutrient beverage enhances the vitamin A and zinc status of Nigerian primary schoolchildren. J Nutr 2011; 141:1565-72. [PMID: 21677073 DOI: 10.3945/jn.110.136770] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Schoolchildren in Nigeria are rarely targeted by micronutrient interventions. We completed a 6-mo, double-blind, placebo-controlled trial to determine the effects of a multi-micronutrient beverage on biochemical and anthropometric indicators of nutritional status among schoolchildren participating in a pilot school feeding program in Nasarawa State, Nigeria. Children received 1 of 2 interventions 5 d/wk during school hours: 1) 250 mL/d of a multi-micronutrient beverage that included vitamin A, iron, and zinc (micronutrient); or 2) an isoenergetic control beverage (control). At baseline, 566 children 5-13 y old were randomized to groups (micronutrient: n = 288; control: n = 278). Height, weight, hemoglobin, and serum concentrations of C-reactive protein, ferritin, retinol, and zinc were measured at baseline and at the end of the study. A total of 270 children in the micronutrient group and 264 children in the control group completed the study. Self-reports of vomiting increased in both groups at 6 mo; however, the prevalence tended to be greater in the micronutrient group (21%) compared to the control group (14%) (P = 0.06). Biochemical changes were greater in the micronutrient group compared to control for serum retinol (0.10 ± 0.02 μmol/L vs. 0.02 ± 0.02 μmol/L; P = 0.016) and zinc (1.0 ± 0.2 μmol/L vs. 0.6 ± 0.2 μmol/L; P = 0.031). The intervention did not significantly affect hemoglobin or serum ferritin concentrations. The cost effectiveness of the intervention needs to be further evaluated, as does the efficacy of the beverage on anemia and indicators of iron status.
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Affiliation(s)
- Grant J Aaron
- Program in International and Community Nutrition, and Department of Nutrition, University of California, Davis, CA 95616, USA.
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Abstract
PURPOSE OF REVIEW Childhood malnutrition is prevalent in developing countries and contributes to one-third of all deaths in these countries. There have been advances in prevention of childhood malnutrition and the purpose of this article was to review the current evidence in the field. RECENT FINDINGS Multiple micronutrient (MMN) supplements during pregnancy reduce the incidence of maternal anemia and small for gestational-age babies. Recent evidence suggest that combined supplementation of MMNs with protein energy supplement is more effective than MMN supplementation alone. It is now recommended that HIV-infected mothers can exclusively breast-feed their infants for 6 months when the mother or infant is on effective antiretroviral therapy. Home fortification of complementary foods reduces the prevalence of anemia in infancy and combined supplementation of MMNs with lipid-based supplements improves growth in young children. Ready-to-use therapeutic foods have been successfully used to manage severe acute malnutrition in the community. Zinc supplementation is associated with a reduction in diarrhea and respiratory disease morbidity and improves linear growth. Vitamin A supplementation decreases the incidence of diarrhea and measles. Water supply, sanitation, and hygiene are important for the prevention of malnutrition because of their direct impact on infectious disease. SUMMARY There is clear evidence on the causes and consequences of malnutrition as well as effective interventions to prevent undernutrition. The next step is to implement these packages of interventions at large scale. A global effort is required that should entail unified and compelling advocacy among governments, lead organizations, and institutions.
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Affiliation(s)
- Aamer Imdad
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
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Shukla G, Sidhu RK. Lactobacillus casei as a probiotic in malnourished Giardia lamblia-infected mice: a biochemical and histopathological study. Can J Microbiol 2011; 57:127-35. [PMID: 21326354 DOI: 10.1139/w10-110] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The study describes the in vivo activity of Lactobacillus casei in malnourished Giardia lamblia-infected BALB/c mice. By experimentation, it was found that daily administration of the probiotic 7 days before inoculation with Giardia trophozoites in malnourished mice efficiently reduced both the severity and duration of giardiasis. More specifically, excretion of Giardia cysts and trophozoites counts were reduced, while faecal lactobacilli counts increased significantly in probiotic-fed malnourished mice, compared with control mice. Interestingly, it was also observed that oral feeding of the probiotic to malnourished mice abrogated all the anthropometric and biochemical anomalies. Histologically, morphological and cellular alteration of microvillus membrane integrity revealed that probiotic administration ameliorated the mucosal damage in malnourished, probiotic-inoculated, Giardia-infected mice compared with the severe microvillus atrophy, œdematous and vacuolated epithelial cells, and ileitis in malnourished Giardia-infected mice. The results clearly show the antigiardial effect of the probiotic in vivo by modulating the gut cells to inhibit the colonization and multiplication of Giardia trophozoites, thus reducing the severity and duration of murine giardiasis.
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Affiliation(s)
- Geeta Shukla
- Department of Microbiology, Panjab University, Chandigarh 160014, India.
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Malafaia G, Talvani A. Nutritional Status Driving Infection by Trypanosoma cruzi: Lessons from Experimental Animals. J Trop Med 2011; 2011:981879. [PMID: 21577255 PMCID: PMC3090609 DOI: 10.1155/2011/981879] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 11/30/2010] [Accepted: 02/17/2011] [Indexed: 01/21/2023] Open
Abstract
This paper reviews the scientific knowledge about protein-energy and micronutrient malnutrition in the context of Chagas disease, especially in experimental models. The search of articles was conducted using the electronic databases of SciELO (Scientific Electronic Library Online), PubMed and MEDLINE published between 1960 and March 2010. It was possible to verify that nutritional deficiencies (protein-energy malnutrition and micronutrient malnutrition) exert a direct effect on the infection by T. cruzi. However, little is known about the immunological mechanisms involved in the relationship "nutritional deficiencies and infection by T. cruzi". A hundred years after the discovery of Chagas disease many aspects of this illness still require clarification, including the effects of nutritional deficiencies on immune and pathological mechanisms of T. cruzi infection.
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Affiliation(s)
- Guilherme Malafaia
- Departamento de Ciências Biológicas, Núcleo de Pesquisas e Estudos Ambientais e Biológicos, Instituto Federal de Educação, Ciência e Tecnologia Goiano—Campus Urutaí, Rodovia Geraldo Silva Nascimento km 2.5, 75790-000 Urutaí, GO, Brazil
| | - André Talvani
- Laboratório de Doença de Chagas, Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisa em Ciências Biológicas (NUPEB), Universidade Federal de Ouro Preto (UFOP), 35400-000 Ouro Preto, MG, Brazil
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Coutinho EM, Oliveira SAD, Barros AFD, Silva FL, Ramos RP. Manson's schistosomiasis in the undernourished mouse: some recent findings. Mem Inst Oswaldo Cruz 2011; 105:359-66. [PMID: 20721475 DOI: 10.1590/s0074-02762010000400002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Accepted: 11/13/2009] [Indexed: 11/21/2022] Open
Abstract
This paper deals with current knowledge of the interrelationships between Schistosoma infection and malnutrition. It emphasizes the relevance of these investigations in the face of dynamic and evolving changes occurring in population diets and changes in the epidemiological patterns of schistosomiasis in endemic countries. The paper further discusses the basis for continuing the studies on this subject and the reasons why it represents a misunderstood association. This review also focuses on the cellular and humoral immune responses in the undernourished mouse model infected with Schistosoma mansoni, with updated information on the immune response in wild-type and iNOS knockout mice concerning soluble egg antigen specific antibodies and kinetics of IFN-gamma, IL-4, IL-10 and IL-13 cytokines, in the chronic phase of Manson's schistosomiasis. There is indication that schistosome-infected undernourished mice are able to develop a humoral immune response, but antibody titres are much lower than in the control animals. Cytokine production (IFN-gamma, IL-4, IL-10) is lower in the undernourished mice, but as infection progresses to the chronic phase its kinetics run an antagonistic course when compared to that of well-nourished animals. Marked variation in the secretion of IL-13 (a fibrogenic cytokine) could explain why undernourished mice do not develop liver "pipe-stem" fibrosis described in previous papers on well-nourished animals.
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Affiliation(s)
- Eridan M Coutinho
- Laboratório de Imunopatologia e Biologia Molecular, Centro de Pesquisas Aggeu Magalhães, Fiocruz, Recife, PE, Brasil.
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Infant Growth During the First Year of Life and Subsequent Hospitalization to 8 Years of Age. Epidemiology 2010; 21:332-9. [DOI: 10.1097/ede.0b013e3181cd709e] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Falagas ME, Athanasoulia AP, Peppas G, Karageorgopoulos DE. Effect of body mass index on the outcome of infections: a systematic review. Obes Rev 2009; 10:280-9. [PMID: 19243518 DOI: 10.1111/j.1467-789x.2008.00546.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
It has not been adequately evaluated whether the outcome of infections differs by body-weight category. We performed a systematic review of relevant studies. Eleven studies (one retrospective and 10 prospective cohort studies) were included in this review, involving a total of 3159 hospitalized patients or nursing home residents. Most studies (6/11) referred to lower respiratory tract infections. Seven studies showed an association of patient outcome (mortality in 6/7 studies) with body-weight category. This was shown in multivariate analysis in 4/5 studies that reported relevant data. Obese or morbidly obese patients with infections had worse outcome compared with the rest of the patients or with normal-weight patients, in 4/7 studies that reported relevant data; findings were not significant in the remaining three studies. Patients in the lowest body mass index (BMI) group had worse outcome compared with all other groups combined, in 3/5 studies that reported relevant data; findings were not significant in the remaining two studies. Low BMI was associated with worse outcome in patients with lower respiratory tract infections in 3/4 relevant studies. Although not consistently reported, an association of both ends of the BMI distribution with worse outcome of infections is plausible and merits further investigation.
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Affiliation(s)
- M E Falagas
- Alfa Institute of Biomedical Sciences, Athens, Greece.
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Guerrant RL, Oriá RB, Moore SR, Oriá MOB, Lima AAM. Malnutrition as an enteric infectious disease with long-term effects on child development. Nutr Rev 2009; 66:487-505. [PMID: 18752473 DOI: 10.1111/j.1753-4887.2008.00082.x] [Citation(s) in RCA: 314] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Malnutrition is a major contributor to mortality and is increasingly recognized as a cause of potentially lifelong functional disability. Yet, a rate-limiting step in achieving normal nutrition may be impaired absorptive function due to multiple repeated enteric infections. This is especially problematic in children whose diets are marginal. In malnourished individuals, the infections are even more devastating. This review documents the evidence that intestinal infections lead to malnutrition and that malnutrition worsens intestinal infections. The clinical data presented here derive largely from long-term cohort studies that are supported by controlled animal studies. Also reviewed are the mechanisms by which enteric infections lead to undernutrition and by which malnutrition worsens enteric infections, with implications for potential novel interventions. Further intervention studies are needed to document the relevance of these mechanisms and, most importantly, to interrupt the vicious diarrhea-malnutrition cycle so children may develop their full potential.
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Affiliation(s)
- Richard L Guerrant
- Department of Medicine, University of Virginia, Charlottesville 22901, USA.
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